Abstract Details

Title Outcomes and Resource Utilization Associated with Readmissions after laser interstitial thermal therapy for refractory epilepsy: A Nationwide Readmission database study (2010-2018)

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S24 - Epilepsy/Clinical Neurophysiology (EEG): Clinical Epilepsy (5:06 PM-5:18 PM)

Poster/Presentation
Number 009

Background Data regarding 30-day readmission rates after discharge post laser interstitial thermal therapy (LITT) for refractory epilepsy remains (RE) poorly reported in literature and understanding factors associated with readmissions will inform future studies aimed at improving quality of care in those with epilepsy

Objective To report the national rates, risk factors, and outcomes associated with 30 days readmissions following LITT for intractable epilepsy.

Design/Methods

Nationwide Readmission Database (NRD) from 2010-2018 was queried using the ICD-9/10 codes in primary diagnosis and procedure field to identify all patients ≥ 18 years who were readmitted within 30 days after hospitalization for LITT for refractory epilepsy. Incidence, etiologies of 30-day readmission and predictors of 30-day readmissions were analyzed.

Results

Among 9763 patients with index admission for (LITT), 945 (9.7%) patients were readmitted within 30 days. Hypertension (24.4%), diabetes mellitus (25.28%), Anemia (10.9%) and Chronic kidney disease (3.1%) were the major comorbidities with significantly higher prevalence among the readmitted group. Compared with the non-readmitted group, the readmitted group had higher incidence of post-operative blood transfusion, CNS infections and CNS complications. Readmissions within 30 days were associated with longer length of stay (6 vs 4 days), greater mean costs ($55021 vs $50898), and increased adverse discharges (11.2% vs 7%) during index hospitalizations. Epilepsy was the most common cause of readmission (24.8%) followed by post-operative infections (22.6%). Hypertension, Anemia, post-operative blood transfusion and CNS infections during index hospitalization predicted higher 30-day readmissions, whereas private insurance (compared to Medicare/Medicaid) correlated with lower 30-day readmission.

Conclusions Approximately 1 in 10 patients were readmitted within 30 days of discharge after an admission for (LITT) for refractory epilepsy, with persistent epilepsy being the most common cause of readmission. Our results suggest that careful management of postoperative seizures and discharge planning after epilepsy surgery may be important to optimize outcomes and reduce the risk of readmission

Authors/Disclosures
Varun Kumar, MD (Arrive Streeterville) PRESENTER	Dr. Kumar has nothing to disclose.
Mark Warman, MD	Dr. Warman has nothing to disclose.
Parisha Bhatia, MD	Dr. Bhatia has nothing to disclose.
Chirag N. Savani, MD (Tampa General Hospital)	No disclosure on file
Tejinder Singh, MD (Reading Hospital- Towerhealth- Division of Neurology)	Dr. Singh has nothing to disclose.
Alfred T. Frontera, Jr., MD (James A. Haley VA)	Dr. Frontera has nothing to disclose.
Selim R. Benbadis, MD, FAAN (University of South Florida)	Dr. Benbadis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stratus. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for SK Lifesciences. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Jazz. Dr. Benbadis has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eisai. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Neurelis. Dr. Benbadis has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sunovion. Dr. Benbadis has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Livanova. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for UCB. The institution of Dr. Benbadis has received research support from Greenwich/Jazz. The institution of Dr. Benbadis has received research support from SK Lifesciences.